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HomeMy WebLinkAbout0015 BRADDOCK DRIVE - Health 15 B"VD0C~K DRIVE MARSTON$ .MILLS k 1-080 \ I r ti. r tns�)t-S6s<a �I TOWN 0� B,� ��STABLE 7M9 OCT 22 PM 3. 31 ' 3 DlVol SION 4 V 3 E 4 f a 1 Vo L t<z f cR �_.n ..:: . _....- ............. LA Tir �^ f w LS t � � f y n I �C1 ; f I Y P � I 4,. 1 ..._..�_. fj .pY C f4l t (ioo o 1 + 4 COMMONWEALTHS OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION David B.Mason,R.S,Certified Title V Inspector,508-833-2177 TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 15 Braddock Drive,Marston Mills,MA Owner's Name: Robert Fenner Owner's Address: 15 Braddock Drive,Marston Mills,MA 02648 Date of Inspection:May 4, 2007 Name of Inspector: (please print)David B.Mason Company Name:_N.A. Mailing Address: 4 Glacier Path East Sandwich,MA 02537 Telephone Number: 508-833-2177 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: Passes Conditionally Passes Needs Further Evaluation by the Local Appr yin Authority ils Inspector's Signature: A Date: The system inspector shall submit a copy of this inspection report to the Approving Aut on (136rd of Health or DEP)within 30 days of completing this inspection.If the system is a shared system or has a esign flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments:System as inspected appears to have operated based on occupancy level. Tank should be pumped as a matter of maintenance. The information as identified represents only the condition of the system on November 1, 2006 at 3:00 PM. Increase in occupancy may result in hydraulie failure. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/I5/2000 page 1 f Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 15 Braddock Road Owner: Fenner Date of Inspection: May 4,2007 Inspection Summary: Check A,B,C,D or E t ALWAYS complete all of Section D A. System Passes: _k 1.have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: Parking area should be defined to prevent parking on septic tank and pump chamber. B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y;N,ND)in the for the following statements. if"not determined"please explain. i _N_ The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfilration or tank failure is imminent.System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A petal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND-explain: _N_ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: N_ The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Ti41r> InenPrtinn Fnrm F./15/D(1tN1 2 l f Page 3 of 11 PART A CERTIFICATION (continued) Praperty Address: 15 Braddock Drive Owner: Fenner Date of Inspection: May 4,2007 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: _ Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well".Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A Titles P-r 6/1 Vlnnn 3 Page 4 of I I CERTIFICATION (continued) Property Address: 15 Braddock Drive Owner: Fenner Date of Inspection: May 4,2007 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No _X_ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _X_ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _NA_ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool NA Liquid depth in cesspool is less than 6"below invert or available volume is less than %2 day flow _X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _X_ Any portion of the SAS,cesspool or privy is below high ground water elevation. _X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone 1 of a public well. T X Any portion of a cesspool or privy is within 50 feet of a private water supply well. _X Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] _NO_(Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd'• You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no _ — the system is within 400 feet of a surface drinking water supply _ the system is within.200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST TitIF 5 lncna+ fine Pnrm A/]ci1)(00 4 Page 5 of 11 it Property Address: 15 Braddock Drive Owner: Fenner Date of Inspection: May 4,2007 Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No _X_ _ Pumping information was provided by the owner,occupant,or Board of Health _X Were any of the system components pumped out in the previous two weeks? _X_ _ Has the system received normal flows in the previous two week period? _X Have large volumes of water been introduced to the system recently or as part of this inspection '? _X _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) _X_ _ Was the facility or dwelling inspected for signs of sewage back up ? _X — Was the site inspected for signs of break out? _X_ _ Were all system components,excluding the SAS,located on site?(INCLUDING THE SAS) _X_ _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum ? _X _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no _X_ _ Existing information.For example,a plan at the Board of Health. _X_ Determined in the field(if any of the failure criteria related to Part Cis at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)] OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Title ; incnpe-6 n Rnrm 611 51NIM 5 r Page 6 of 11 PART C SYSTEM INFORMATION Property Address: 15 Braddock Drive Owner: Fenner Date of Inspection: May 4,2007 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):3_ Number of bedrooms(actual):3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms):330 Number of current residents: Does residence have a garbage grinder(yes or no):NO(Not Allowed) Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no):NA Seasonal use: (yes or no):NO Water meter readings,if available(last 2 years usage(gpd)): 2006;41,000gpd 2005; 52,000gpd Sump pump(yes or no):NO Last date of occupancy. Current COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system (yes or no):_ Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Mashpee Board of Health Was system pumped as part of the inspection(yes or no):NO If yes,volume pumped:_gallons--How was quantity pumped determined? Reason for pumping:Maintenance pumping conducted after inspection TYPE OF SYSTEM _X_ Septic tank,distribution box, soil absorption system _Single cesspool _Overflow cesspool _Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank _Attach a copy of the DEP approval _Other(describe): With pump chamber Approximate age of all components,date installed(if known)and source of information: approx. 24 years Were sewage odors detected when arriving at the site(yes or no):NO OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Tifls r, Inc—fin" Pnrm till';,90 0 6 Page 7 of i l PART C SYSTEM INFORMATION (continued) Property Address: 15 Braddock Drive Owner: Fenner Date of Inspection: May 4,2007 BUILDING SEWER(locate on site plan) Depth below grade: Approx. 30 Inches Materials of construction:_cast iron _X_40 PVC_other(explain): Distance from private water supply well or suction line:_NA Comments(on condition,of joints,venting,evidence of leakage,etc.): Appears in good condition. SEPTIC TANK: N.A.(locate on site plan) Depth below grade: 26 Inches Material of construction:_X_concrete^metal_fiberglass_polyethylene _other(explain)_ If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: Typical 1000 gal. Sludge depth: 4 inches Distance from top of sludge to bottom of outlet tee or baffle: 28inches Scum thickness: variable 0 inches to 6 inches Distance from top of scum to top of outlet tee or baffle: 0 inches Distance from bottom of scum to bottom of outlet tee or baffle:Not applicable no scum at outlet tee How were dimensions determined:actual measurements Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.)inlet tee is PVC.Outlet tee is PVC and appears in good condition. No evidence of leakage. Structure of tank appears adequate.Effluent level with outlet tee. Maintenance pumping is required. GREASE TRAP: N.A. Depth below grade: _ Material of construction:_concrete_metal._fiberglass polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert;evidence of leakage,etc.): OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Title'; lnenvrtinn Fnnn h/1 G/)(10 1 7 Page 8 of l l PART C SYSTEM INFORMATION(continued) Property Address: 15 Braddock Road Owner: Fenner Date of Inspection: May 4,2007 TIGHT or HOLDING TANK:—N.A.—(tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass_polyethylene other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: YES_(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Level with outlet invert Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): There is no indication of solids carryover,dbox is in good condition. Dbox is approx.3 feet below grade.Utilized camera to view distribution box. PUMP CHAMBER:,(locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM TitiP G Tnenantinn Rnrm 6/1 i/101)() 8 Pag 9 of I I PART C SYSTEM INFORMATION (continued) Property Address: 1.5 Braddock Drive Owner:Fenner Date of Inspection: May 4,2007 SOIL ABSORPTION SYSTEM[(SAS):_X (locate on site plan,excavation not required) If SAS not located explain why: Type _X_leaching pits,number: t Pit;6 foot depth leach pit with approx. 2 feet stone. leaching chambers,number: _leaching galleries,number: leaching trenches,number,length: _leaching fields,number,dimensions_ overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): leaching is 48 inches below grade. Leach pit is below driveway,Riser is not present. No indication of ponding,nor increase growth of vegetation. CESSPOOLS:_NA_(cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY:_N.A._(locate on site plan) Materials of construction: Dimensions: _ Depth of solids: Comments(note condition of soil, signs of hydraulic failure,level of ponding,condition of vegetation,etc.): OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM TitlE. C jncnartinn 1~nrm Fri C0nnn 9 i Page 10 of I 1 PART C SYSTEM INFORMATION(continued) Property Address: 15 Braddock Drive Owner: Fenner Date of Inspection: May 4,2007 SKETCH OF SEWAGE DISPOSAL SYSTEM Pro,ide a sketch of the sewage disposal system including ties to at least two permanent:reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. A B W Septic Tank C-1 18' B-1 17' Distribution Box B-2 18' A-2 1.7' Leach Pit B-3 49' A-3 32' OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL. SYSTEM INSPECTION FORM Titl'a S 10 Page 11 of I 1 PART C SYSTEM INFORMATION(continued) Property Address: 15 Braddock Drive Owner: Fenner Date of Inspection: May 4, 2007 SITE EXAM Slope Surface water Check cellar (crawl space) Shallow wells Estimated depth to ground water_20 feet Please indicate(check)all methods used to determine the high ground water elevation: _X_Obtained from system design plans on record-If checked,date of design plan reviewed: _X_Observed site(abutting property/observation hole within 150 feet of SAS) _X_Checked with local Board of Health-explain: Recent Test Holes, Existing engineer records with BOH _X_Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Utilized existing site design information on file with the Board of Health. Additionally,existing site and abutting site topography does not indicate ground water to be within 4 feet of bottom of leaching facility. The surface ground elevation at the site,is 56.0. Ground water elevation is 39.0. A difference of 17'. The pit is 4 feet below grade,thus 7 ` above ground water elevation. Information based on Town of Barnstable topography and ground water contour map. TiOP '; lncnr nfvnn Fnrm AA i0ll 1!1 11 -ttr I " /of -, 0�0 LOCAT19N SEWAGE PERMIT74 M VILLAGE �INSTA LLER S NAME i ADDRESS C'-X�90 a e U 1 L D E R OR OWNER rejs�c a DATE PERMIT ISSUED �Zs- 3 DATE COMPLIANCE ISSUED � L 1 �%1 p i� I� �e i �i..� rfl `� - No r !� FEic THE COMMONWEALTH OF MASSA&HUSETTS BOARD OF HEALTH Town Barnstable ...................... ................... ..O F........................................---...........---.--......_..---.................. Apphration for j3iopoiitti Worko Tomitrurtiort Prrutit Application is hereby made for a Permit to Construct (x ) or Repair ( ) an Individual Sewage Disposal System at L,ot # 18-Braddock Drive, Marston s Mills 14A ..... ............ ......................... ............- Capricorn Rea�` yArust 765 Falmouth R�aLdt$N°1'yannis . .......... --......_...............................................................•••........ .............---------•••-------•••....•-••-••--•-••.....--••---••....--•••-•--•--•--•---••.•----• w Steve Lebel owner Address Installer Address d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building No. of persons.......................... Showers a g ranch--.-.•.--•---- p -- (2 ) — Cafeteria ( ) dOther fixtures .........-•-•--•--•--•-•--••-•-•----•-••-•-•---••-----.--...•-----------------•--•••••-•-•--•............--------------•-...---....-----...-•••..•---• Design Flow........ 5................................gallons per person per day. Total dai,l}' flow.........330............................gallons. 1:4 —Liquid capacity1000•_gallons Lengtl Septic Tank _�_6��..__.. Width�_1v�..._ Diameter________________ Depth.2............. W Disposal Trench—No. .................... Widt _._._...__._.__.__._ Total Length.......__ ... Total leaching area.._.....____ sq. ft. Seepage Pit Nol.:................. Diameter.._. �..._...... Depth below inlet....6�........... Total leaching area.-............sq. ft. z ( ) Y..........................................................Aldred )e En ineerin Date___11-2- -81 Other Distribution box Dosing tank Percolation Test Results Performed b g..._......_._ ................_..... ,aa Test Pit No. 12. ...._..minutes per inch Depth of Test Pit..1L.__........ Depth to ground watePone._.encounter- Gi, Test Pit No. _N!-A...._....minutes per inch Depth of Test Pit11IA..._._._.... Depth to ground water..ryl .............. e P4 ...... ..-- -----•---..... ---....... .................•••--......•-•......................................................... O Description of Soil.........9�---•-•-2-'----....loam-& topsoil______________________________ •--- -••----•---•---------------•--------------- v 2� - 10� Iviedium yellow sand ---------------•---------------•--••--•-------------•------------.--.............------ . ----....... 10 - 12 med. white sand traces of ravel no water at 12 W •.•-------------------------•••-•••••-••---•.................:-•--•-. ----•-------•-•-.....----------•--------------------------- -----------•--�---••-......-•�--• ••------........-----------•- V Nature of Repairs or Alterations—Answer when applicable...................................................................................._........_.. ----------------------------•---•--•----------•-•--•----•--•---•--••---...------------......................-•----------------------•------------------•--------------•-------------------..........---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of AI'11Z 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliances en rsued b the oar f health. Si Pres. 2 8 •.•-- -- - ---- -------------------------•-- 9� .•. ........... Application Approved BY-----.----- .... ...�P'il .... ... -...... 11 �� . .............. C Date Application Disapproved for the ollowin reasons:.....K5..................... ....................................................... .................- -•............................•--•-••--..................._..................•----------••••••--------•-'---•-•--••--._.._.................-•-•-------------•------ --------- Date PermitNo......................................................... Issued........................................................ No.. 3 —7: ` FEB... , f THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALT14 Tov,,n Barnstable ....... ............. ....................O F.......................... .-.-........ Appliration for Uiopoottl Workii Tonotrnrtion amit Application is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal System at: 1- Lot d 18-Braddock Drive, Marstons Mills RiA .._•................�.-------•-................-•-•----------..............-•-••-•••-•-•-••-•-_.. ..._..._......------••-•-•----- ............................................................. Loc io -Adess Capricorn Remy . rust 7b5 Falmouth Road;°'Hyannis .............----....... •. ..._.....---- ..... ----•-------.................---• ...........-----•---..._-- •• ........ W Steve Label Owner Address ----••••-•-•-----...----•-••--•-........---••--••---•-•..................................••-•----• --•---...-•----------------....------........•----.................--•-•..................-•-_.... Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms..........................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building z'a219h.............. No. of persons............................ Showers (2 ) — Cafeteria ( ) Otherfixtures .----....--••------•.......................•----------••-----•---_....•-•-•--•--•-•-••-•----••---._.....---------:.__._...._........ ....... WDesign Flow........55...:..........................gallons per person per day. Total daily flow.........319........................... allons. W Septic Tank—Liquid capacity 00111 0-gallons Length..6........ Width�._1._...... Diameter................ Depths.._$....... x Disposal Trench—No. .................... Widt _�................. Total Length....... .�_.......• Total leaching area.........___ sq. ft. Seepage Pit Nol___________________ Diameter...._ ._-_.__..__. Depth below inlet....6............ Total leaching area...2bb......sq. ft. Z Other Distribution box ( ) Dosing tank ( ) `-' Percolation Test Results Performed by..-- Engineering Date_._11-25-81 Test Pit No l.2!.�_.....minutes per inch Depth of Test Pit___12_.......... Depth to ground water olle .enCOunter- A p p 11IA........... Depth to ground water..ly. ... e G>~ Test Pit No. __.._...___minutes per Inch Depth of Test Pit.. ---------- •----•--------•---------•-•-------•---•-------------•••--------.....----..........._--••----••-••............................................................ O Description of Soil.........Q•' -..2" loam `&• topsoil...... .._.....----•...............•-•_...-- x 2' - 10' Niedium yellow sand W 10' - 12' med. white sanditraces of ravel no water at 12' ...••-•----•----------------------••-----------.-------------------- -----•---•••-•------•-•-----•----•----•--------------•-••...-----•-••...--•_ j--.•-------•-•-•-------••-•...... V Nature of Repairs or Alterations—Answer when applicable............................................................................................... -----------------•--•------------------•----•---------••--•----------•---............---...---•••••.----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T1TLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Sign ire s. 9�22�8 _... ................................. ----------- Approved B � '� " ' - !� s �:I? < f� .... ..... ....... Date._.........._ E Application Disapproved-for the ollowan /reasons:__. S --••--•------------••-••.....--•-...-•--•••---•---.---•----.....--•••-•-------•••---------------------•---•-----..........--•------••----•----....•-••-------------•-----•--------•--•----•-••-----•-- Date PermitNo......................................................... Issue .......................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........T.o}v?1.................OF.......garn5 tale .. ...................................•--.............. (9rdifiratr of Toutplittnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (X ) or Repaired ( ) by--------------------------------------------------Steve Lebel ---••---••---------------------------•--••----------------_-.---------------•---•---..._--•------•-- at........_ .................1 -'•-r�'addock Drive, Installelia-rstons Mills , f:SA - -- --------------------------- ---- -- -----------------------------------------._.._.•------------ ----- has been installed in accordance with the provisions of T TLF, 5,�.00f T State Sanitary Code as e c ' ed in the application for Disposal Works Construction Permit No. __"_ _< _.__.___. dated_-..r'r?_ -.�.s ............... THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS. U RANTEE THAT THE SYSTEM 1ly/I,I,C P)ACTION SATISFACTORY. DATE...r�/ �1{•/ ...................................................... Inspector.........._... ..a...........------------•--••-•-----.......-------•-••-......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH T of-dn Barns tabl e w 1 NFEE......... ........... _ �io�oonl orko �on��rion rrmi� .. Steve Lebel Permission Is hereby granted ..--------. to Constu =Illt Repair _ aK In ividual Sewace Disposal System stem�r ctocrive � •-"�at.No..--.•- 0 _7�...................................................... rTlarsonsM Mills _ • ` l --.................. ...... ........... Street y as shown on the application for Disposal Works Construction Permit No........ ..... . ated. ....... ....... .... .. ......... •- �' Board of alth DAT . ............ � FO M 1255 A. M. SULKIN, INC., BOSTON ,✓d 7E 7 . � Q �ifi• s.o,. _ T� . yr Se S' P\jN OF Mgss RSE No.10951 440 ; r) . 20A O 4 2 .7 IV � 90 G/S-rs �FSS/ONAi-ENG� 3U//s bj 91.00 LEGEND N6z "36 zj EXISTING SPOT ELEVATION Oxo M s CERTIFIED PLOT PLAN EXISTING CONTOUR --- 0 -- - Lo 7- FINISHED SPOT ELEVATION FINISHED CONTOUR 0 70. 57T4/�s' e/cs. ROBERT I N APPROVED BOARD OF HEALTH eRucE � =:1 ' ECDR6 v' S"t4g'. j ASS DATE AGENT .tier.: e r,r, fA SCALES = 3 D DATE S /o ) v EVL DREDGE ENGINEERING CQ IN `�'' `% 'f✓ca CLIENT I CERTIFY THAT THE PROPOSED EGISTERE REGISTERED ,JOB NO. S� BUILDING SHOWN ON THIS PLAN CIVIL LAND CONFORMS TO THE ZONING LAWS ENGINEER SURVEY R DR.BY A-,11 '1 OF BARNSTABLE, MASS. 712 MAIN STREET CH. BY, L a,£" HYANNIS, MASS. / . _ -, SHEET__. OF DATE N D EG. Lti SURVEYOR 20 FT. M//V. N07 e /F EITHER THE SEPT/C TA�,V k OR LE/�GH/iYrT P/T A tE /YORE TN.g/V /2•'BELOJV /O Prr. M/N. GR.4OE, A 24'O/AMETER C'ONC"RET� COiiER CONCRCTE 4'PVC' pip-- BE B.POIJGHT TO GdgAOE. �AN ,EX7"RA MIN. P/TCN �EA vY CAST /RO/Y CO I/ER Sf�.4 G L BE USFl� I •.: _ _ CDI�ERS �B"PFR FT /FIN OR/VA=WAY V2 MAN. CD/VC e&TE A _ G AoE CO IiER CLEAN SANG •^ 4"CAST - z.ay'' 2•4AYER tIRON P/PF o /�8'•_3�B" 'v MIN.P/TCN /D 0 0 &A4. ° • e' • • . . • .. • • • b'•40 PER D/ST, o WASHED SMNC • SEPT/C TANK o b • • • • • • • • • • e i 1J:;, I O • o • 1 8 • r • • • i •rbo OF ••,�,. • • o • � •EFFECT%VL ' • . 3 4 - � 2 :'Q; • o n ► • • pEPTH • • • r v o 1VASHEp STOiYE lF��'X ZS= 47o e q e • • • • • • • • . ' Op o 7 0 x l,0 7 8 • 00 A 0 • • • • • • • • p • ST SEEPAGE /N//,�i!'T ELE✓AT/GNS h/r C^ 71A ciT•y .S'4$'csf�/���Y ° ►" ' ' • ' • • ' • ' a `p PRECA o R17 OR EQU/V. • OF e EL. 5�G•o INVERT AT OL/!LD//VG -S3•0 FT. Id INLET SEPT/C TANK Sz.Fr'FT, FT. O44M. C(SEE 7;kWV A-rlOA�) OUTLET SEPTIC TANK //VLFT DISTRlf3UT/ON BOX 5z-4 FT. S.ECTyON GROuNo WATER 7AOI-E Ot/TLETD/STR/BIlT/ON BOX 5 -ZFT //VLET LEACHING 0=/T s2.0,�T SELVAGE AP SP4MA L SYS7',6M TABULATION L EACf1/NG P/T D/MENS/ON A -3 ITT. DESIGN CR/TER/A sCAL,- : %R" _ /= o" 0/MAWS10" $ 6 FT. NUMBER OF BEDROOMS 3 D/MENS/ON C _FT.M 1 A . GAReAGED/SPOSAL UNIT "Aff SOIL LOG TOTAL EST/MATED FLOH/ 33 Cl GAL.1DAY SOIL TEST Ak1 SOIL TLC'ST#,� SOIL TEST NUMBER OF L,E54CXlVG P/T,S_/ r ,DATE OF SO/L. TEST S/DE LEACHING PER P/T 1 gs' SO. FT. _ RESULTS N//TNESSED BY Ra C- c1A co3/ BOTTOMLE,4GN/NG PER P/T�$(a• �T o ��M2� •�'ERCOAAWON /LATE / LEss M/hh/1NCH TOTAL LEACH/NG AREA SQ, FT. �- svr3 S of L AEhCOLAT/ON RA7'E 02 T� MIM. INCH RESERl�ELEACHlNGAREA �6 b SQ. FT. -(b z. \O �OFOF� uMBT�'Ao0[�cK O/Z/Vic 4 ROSERT ��' �� A G w' PIRUCE E ;:`RcOG o (' Wsl TCR MORSE �.. -< k� �, No.iossi�o ELOREDGE E/VG/NEV)?/NG CO,/NC. Li 7t2 MAIN sr, !•IYANN/9, MASS. Fsc�ONAI.EN� ❑ NDG OUN yY 7-&M E O L/ T: /� D A NCOU/VTERE C EN FRS iVC.O D,4TE'/0 1 q 8"3 L� GROU/VO 1�/.ATE.P AT ELEI/ 38 3 JOB NO. 3 -j-5 G. sNT of 2- 6 f 18 14 I I I i 5' I I 2' I I L ------------------ I i I I I I I I 14' - 28' New New Garage . Existing House I 1r1i ------------------ -- I 6' I . I a I I 3' --------- --------------- ---' ^h i 1� 1 11 r.� Y ..